Tisdale, Bernard Alvan
Tisdale, Bernard Alvan is an individual health care provider with primary practice located at 1109 W Marshall St , Richmond VA 23220-3835. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Tisdale, Bernard Alvan can be contacted via phone (804) 257-7337.Contact Information
Primary practice address
1109 W Marshall St
Richmond VA 23220-3835
Phone: (804) 257-7337
Fax: (804) 359-6898
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | 0101040236 | Virginia |
Profile Details
| NPI number | 1124009600 |
|---|---|
| LBN Legal business name | Tisdale, Bernard Alvan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 10th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124009600 | NPPES |
| Virginia | MEDICAID | 5866740 |
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